Outpatient monitoring systems and methods

ABSTRACT

Described are computer-based methods and apparatuses, including computer program products, for outpatient monitoring. In some examples, the outpatient monitoring technology includes a system for remote monitoring and consultations of patients&#39; state associated with automated interpretation of vital signs signals. In other examples, the outpatient monitoring technology includes a system for remote monitoring of patients&#39; state associated with analysis of full-disclosure vital signs digital signals with reduced bit data or channel data. In some examples, the outpatient monitoring technology includes a system for remote monitoring of patients&#39; state associated with ongoing automated analysis and transmission of full-disclosure vital signs digital signals and automatically generated signals&#39; interpretation results and manually marked patient symptoms.

RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No.61/236,602, filed on Aug. 25, 2009, and U.S. Provisional Application No.61/115,214, filed on Nov. 17, 2008, the entire teachings of the aboveapplications are incorporated herein by reference.

BACKGROUND

Use of telemedicine can have a significant impact on individual healthand can therefore favorably impact longevity. The value to the economyfor these improvements in life expectancy is about as large as the valueof all other consumption goods and services combined. In this regard,certain health services can be greatly enhanced via telemedicine. Forexample, home health services are receiving a great deal of attentionand investment in many countries around the world. Telemedicinetechnologies enable home health providers to redefine patient treatmentplans, as they are able to increase virtual patient visits through theelimination of a significant percentage of travel to patients' homes. Inaddition, in many situation outpatient monitoring allows forhospitalizations prediction, which results in actions leading toavoiding such expensive procedures. Further, access to quality, state ofthe art health care in underserved areas, such as rural communities, isone of the most important promised benefits of telemedicine. Ruralresidents are not second-class citizens; they deserve access to healthcare services that those in metropolitan areas enjoy.

An example of popular telemedicine applications are long-term,outpatient arrhythmia diagnostic systems, where patients are monitoredfor several weeks, while staying at home or carrying their normal lives.These systems utilize a concept of transmitting short ECG fragments,when an important cardiac event occurs. In more obsolete applications,the event transmissions are manually triggered by the patients, whilemost recent applications use intelligent algorithms, operating inreal-time, which based on automatically detected events, trigger thetransmissions. Both of the above applications can be viewed as so-called‘event systems’, because they transmit only short ECG fragments,representing limited events only. Diagnostic reports from such systemsusually contain limited, in terms of statistical representation,information describing the normal and abnormal heart rhythm and producequalitative rather than quantitative results. On the contrary, the socalled ‘Holter systems’, popular applications for short term (usually 24hours or 48 hours) arrhythmia diagnostics, allow for reviewing theentire full-disclosure ECG signal and verifying classification resultsfor each heart beat, hence they are capable of producing qualitative andcomprehensive statistical reports, with each heart beat counted andclassified. The ‘Holter systems’, however, are offline applications,where the ECG signal is stored by ‘Holier recorders’ carried by thepatients, and after the diagnostic session is completed, the recordersare returned to a physician/specialist for data download and automatedanalysis and post-processing.

Thus, a need exists in the telemedicine field for outpatient monitoringsystems and methods allowing for generating more quantitative analysisresults.

FIELD OF THE INVENTION

The present invention relates generally to computer-based methods andapparatuses, including computer program products, for outpatientmonitoring.

SUMMARY

One approach to outpatient monitoring is a system for remote monitoringand consultations of a patients' state associated with automatedinterpretation of vital signs signals. The system including at least oneportable monitor, each portable monitor configured to: acquire datasignals representative of a patient's vital signs; interpret therepresentative data signals; and generate interpretation result data;and transmit the interpretation results and the vital signs signals. Thesystem further includes at least one monitoring computer station, themonitoring computer station including: a downloading module forobtaining the data signals representative of the patients' vital signsand the interpretation result data; a display module for viewing theobtained data signals representative of the patients' vital signs andthe interpretation result data; a revision module for correcting and/oraffixing comments to the interpretation result data; and asynchronization module for synchronizing the revised interpretationresult data with a data interpretation center and repository.

Another approach to outpatient monitoring is a system for remotemonitoring of patients' state associated with analysis and transmissionof full-disclosure data signals having reduced bit data and/or reducednumber of channels, representative of patient's vital signs. The systemincludes at least one portable monitor configured to acquire, store andcompress/reduce data signals representative of patients' vital signswith a lossy compression/bit reduction algorithm I channel reductionprocedure; and transmit the compressed data signals along with someuncompressed vital signs signal data fragments. The system furtherincludes at least one monitoring computer station, the monitoringcomputer station including a downloading module for obtaining thecompressed/reduced data signals and the uncompressed/unreduced datafragments; and a verification module visually distinguishing between thecompressed/reduced data signals and the uncompressed/unreduced datafragments.

Another approach to outpatient monitoring is a system for remotemonitoring of a patients' state associated with ongoing automatedanalysis and transmission of full-disclosure data signals representativeof vital signs, interpretation results data, and manually marked patientsymptoms information data. The system including at least one portablepatient monitor, the portable patient monitor including an acquisitionmodule for acquiring digital data signals representative offull-disclosure vital signs; an analysis module for interpreting theacquired digital data signals; an interactive user interface forreporting subjective symptoms; a recording module for storing thefull-disclosure data signals representative of vital signs, theinterpretation results, and the information entered via the userinterface; and a transmission module configured to transmit the datasignals representative of full-disclosure vital signs, theinterpretation results, and the information entered via the userinterface.

Another approach to outpatient monitoring is a method for remotemonitoring of patients' state associated with interpretation resultsdata representative of the patients' vital signs. The method includingthe steps of remotely initializing at least one monitoring sessionhaving an associated unique identification number; obtaining thesessions' identification number; associating a patients' personal dataand a consultants' personal data with the obtained sessions'identification number; transmitting vital signs signals withinterpretation results; verifying the interpretation results data and/orpost-processing the received signals data and/or inserting comments tothe interpretation results data; and synchronizing the verified orcommented on interpretation results data with a data interpretationcenter and repository.

Another approach to outpatient monitoring is a method for remotemonitoring of a patients' state associated with analysis offull-disclosure data signals representative of vital signs having areduced bit data/reduced number of channels. The method including thesteps of receiving bit-reduced and/or channel-reduced full-disclosuresignals data representative of a patients' vital signs anduncompressed/unreduced data signals fragments; visually reviewing thecompressed/reduced full-disclosure signals data representative of apatients' vital signs and the uncompressed data signals fragments; andremotely requesting additional uncompressed/unreduced data signalsfragments for a more detailed analysis and/or verification.

Another approach to outpatient monitoring is a method for remotemonitoring of a patients' state associated with ongoing automatedanalysis and transmission of full-disclosure signals data representativeof a patients' vital signs, automatically generated interpretation dataresults, and manually marked patient symptoms information. The methodincluding the steps of receiving, in a remote location, datarepresentative of a patients' full-disclosure signals withinterpretation data results and manually marked subjective symptomsinformation; reviewing, from the remote location, the datarepresentative of a patients' full-disclosure signals with theinterpretation data results and the manually marked subjective symptomsinformation; and reporting, from the remote location, the interpretationdata results and the manually marked subjective patient symptomsinformation.

Another approach to outpatient monitoring is a computer program product,tangibly embodied in an information carrier, the computer programproduct including instructions being operable to cause a data processingapparatus to perform any one of the approaches and/or examples describedherein.

Another approach to outpatient monitoring is a system for remotemonitoring and consultations of a patients' state associated withautomated interpretation of vital signs signals. The system including atleast one means for portable monitoring, each means for portablemonitoring configured to acquire data signals representative of apatient's vital signs; interpret the representative data signals; andgenerate interpretation result data; and transmit the interpretationresults and the vital signs signals. The system further including atleast one monitoring computer station, the monitoring computer stationincluding means for obtaining the data signals representative of thepatients' vital signs and the interpretation result data; means forviewing the obtained data signals representative of the patients' vitalsigns and the interpretation result data; means for correcting and/oraffixing comments to the interpretation result data; and means forsynchronizing the revised interpretation result data with a datainterpretation center and repository.

Another approach to outpatient monitoring is a system for remotemonitoring of patients' state associated with analysis and transmissionof full-disclosure data signals having reduced bit data and/or reducednumber of channels, representative of patient's vital signs. The systemincluding at least one means for portable monitoring configured toacquire, store and compress data signals representative of patients'vital signs with a lossy compression/bit reduction algorithm/channelreduction procedure; and transmit the compressed/reduced data signalsalong with some uncompressed/unreduced vital signs signal datafragments. The system further including at least one means formonitoring, the means for monitoring including: means for obtaining thecompressed data signals and the uncompressed/unreduced data fragments;and means for visually distinguishing between the compressed/reduceddata signals and the uncompressed/unreduced data fragments.

Another approach to outpatient monitoring is a system for remotemonitoring of a patients' state associated with ongoing automatedanalysis and transmission of full-disclosure data signals representativeof vital signs, interpretation results data, and manually marked patientsymptoms information data. The system including at least one means forportable patient monitoring, the means for portable patient monitoringincluding means for acquiring digital data signals representative offull-disclosure vital signs; means for interpreting the acquired digitaldata signals; means for reporting subjective symptoms; definingsymptom's characteristics; and defining patient's activity andcircumstances related to the symptom's occurrence; means for storing thefull-disclosure data signals representative of vital signs, theinterpretation results, and the information entered via the userinterface; and means for transmitting the data signals representative offull-disclosure vital signs, the interpretation results, and theinformation entered via the user interface.

In other examples, any of the approaches above can include one or moreof the following features.

In some examples, the portable monitor operates in real-time andcontinually generates the data signals representative of the patients'vital signs, the interpretation result data, and a hardware status dataof the at least one portable monitor.

In other examples, the hardware status data contains informationdescribing the portable monitor's battery status, memory status andmobile telephony communication error list.

In some examples, the data interpretation center and repository receivesthe data files from the at least one portable monitor, reads the datasignals representative of the patients' vital signs and inserts theinterpretation result data, with links to the data signalsrepresentative of the patients' vital signs, into the data repository.

In other examples, the at least one monitoring computer stationssynchronizes remotely with the data interpretation center andrepository.

In some examples, the revised interpretation result data are propagatedto the data interpretation center and repository and distributed furtherto the at least one monitoring computer station connected with the datainterpretation center and repository.

In other examples, the at least one portable monitor selects theuncompressed/unreduced data fragments based on generated interpretationresults and/or a signal condition representing at least one significantsignal event.

In some examples, the verification module of the at least one monitoringcomputer station remotely requests additional uncompressed/unreduceddata fragments stored in the at least one portable monitor's memory foradditional review.

In other examples, the additionally requested uncompressed/unreduceddata fragments and the compressed/reduced data signals are visuallydistinguished by the at least one monitoring computer station with theuse of the verification module.

In some examples, the at least one portable patient monitor triggers thedata transmission based on the interpretation results, the patient'sinteraction, or on a periodic schedule.

In other examples, the interactive user interface allows for definingsymptom's characteristics; and defining patient's activity andcircumstances related to the symptom's occurrence.

In other examples, the sessions' identification number is a combinationof the session initialization time, date, and a portable monitor'sidentification number.

In some examples, the method further including creating an event listbased on interpretation results data, each event having an unconfirmedstatus indicator.

In other examples, the method further including changing the unconfirmedstatus indicator to a confirmed status indicator when the event has beendetected properly, deleted, determined to be a false event, determinedto be unclear, or when the consultant is not sure whether it is a trueevent or an incorrectly detected event.

In some examples, the method further including correlatinginterpretation data results with the manually marked, subjective patientsymptoms information.

In other examples, the method further including generating monitoringreports including the interpretation data results correlated with themanually marked subjective patient symptoms information.

In some examples, the monitoring reports are generated on an ongoingbasis, during the patient monitoring, and at the end of the monitoringsession.

An advantage to the outpatient monitoring technology quantitativeanalysis results can be generated by accessing remotely thefull-disclosure signals, thereby enabling detailed post-processing ofthe data, detailed verification of the analysis results, and moreconfidence in generating qualitative analysis reports.

Other aspects and advantages of the present invention will becomeapparent from the following detailed description, taken in conjunctionwith the accompanying drawings, illustrating the principles of theinvention by way of example only.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other objects, features and advantages will beapparent from the following more particular description of embodiments,as illustrated in the accompanying drawings in which like referencecharacters refer to the same parts throughout the different views. Thedrawings are not necessarily to scale, emphasis instead being placedupon illustrating the principles of the embodiments.

FIG. 1 is an illustration of vital signs signals outpatient monitoringand tele-consultations system;

FIG. 2 schematically illustrates full-disclosure signal data flow;

FIG. 3 schematically illustrates tele-consultations data flow;

FIG. 4 is an illustration of the real-time outpatient interactive andfull-disclosure vital signs signals monitoring system for symptomaticevents recording and correlation with automatically detected signalevents;

FIG. 5 is a flowchart illustration of a method for remote monitoring ofpatient's state associated with interpretation results datarepresentative of patients' vital signs;

FIG. 6 is a flowchart illustration of a method for remote monitoring ofpatients' state associated with analysis oflossy-compressed/bit-reduced/channel-reduced full-disclosure vital signssignals; and

FIG. 7 is a flowchart illustration of a method for remote and real-timemonitoring of patient's state associated with analysis offull-disclosure vital signs signals.

DESCRIPTION

Outpatient monitoring technology can include a system enablinglong-term, outpatient and real-time analysis of vital signs signals,where the data is transmitted via a bandwidth-limited communicationchannel, such as mobile telephony network, during the diagnostic sessionon an ongoing basis. The outpatient monitoring technology can have thebenefit of access to full-disclosure signals. The technology enablesgeneration of more comprehensive and qualitative statistical analysisresults on an ongoing basis and real-time response to the automaticallydetected events requiring immediate reaction, or to the symptomaticevents reported by the patients during the monitoring. The technologyalso allows for correlating the symptomatic events, reported by thepatients, with the full-disclosure vital signs signals and theautomatically generated signal description.

The outpatient monitoring technology can include a system for outpatientmonitoring of patients' status, based on automated analysis of vitalsigns signals. The vital signs signals can be acquired through a sensorin a portable patients' monitor. The portable monitor can analyze thesignals in real-time and can generate vital signs interpretationinformation including, for example, information for emergency cases.Based on the interpretation results, significant events associated withpatient state are detected. In addition, the acquired vital signssignals are compressed/downsized with lossy-compression/bit-reduction orchannel-reduction algorithm which generally decreases quality of thevital signs signals, or reduces information contained by the signals,but enables transmission of the continuous, full-disclosure signalsthrough a bandwidth-limited communication channel (e.g., mobiletelephony network, wired telephony network, etc.) to a specialist at aremote location. In addition, based on the automated interpretationresults, i.e., in accordance to the determined events, short,uncompressed/unreduced vital signs signals fragments are selected. Thefull-disclosure, lossy-compressed I bit-reduced, or channel-reducedsignals along with the selected uncompressed/unreduced fragments and theinterpretation results can be stored in digital files and transmittedvia the bandwidth-limited communication channel, with the use of anytype of transmission mechanism, e.g., file transfer protocol to a remotesystem server connected to the Internet. The entire vital signs signalscan be stored in the portable patients' monitor in anuncompressed/unreduced format for later reference. When a new monitoringsession is initiated with the use of the portable patient's monitor, asession unique ID number can be generated and/or can be stored in thesession's initialization digital file. The ID number can be acombination of the initialization time and date and the device unique IDnumber. The system server can receive the data files and can insert theinterpretation results with links to the transmitted data files to adatabase. Once the server detects a new monitoring session ID file, theserver can create a new folder for storing the session digital files,and can create a new record in the database. The vital signs signalsmonitoring computer stations can have access to a network (e.g.,internet, local area network, etc.), and can connect remotely to thesystem server and the database, can download the monitoring digitalfiles, and/or can display information about the newly initiated session.When the new session is detected by the monitoring center's consultantswith the use of the monitoring computer stations, the monitoringcenter's representative contacts the portable monitor's owner/user,e.g., a physician or a patient in remote location, and obtains personaldata, medical history and other information regarding the monitoredperson and inserts it to the system server's database. The informationcan be also inserted directly to the system server's database, by theowner/user of the portable monitor, via a web browser, through a webbased interface.

In some examples, personal data of all consultants responsible foranalyzing the patient's vital signs signals during the monitoringsession and personal information of the user/owner of the portablemonitor who initiated the monitoring session from remote location can beinserted to the system server's database and can be associated with themonitoring session's record. The vital signs monitoring computerstations databases can synchronize with the system server database andcan download the monitoring session data files. The consultants canreview the full-disclosure vital signs signals with the attachedinterpretation information in order to verify the automated analysisresults. The consultants can post-process the received full-disclosuresignals in order to generate more complete statistical reports. Allevents, automatically detected by the portable patients' monitor and/orevents generated during the post-processing procedure can have theinitial status set to “unconfirmed”. The operators can verify and reviewthe events. The operators can change the status to “confirmed” if theevent has been detected properly. The operators can change the status to“deleted” in case of false events. The operators can change the statusto “unclear”, in case of doubts, so other operators can consult theevent.

In other examples, the consultants can modify events description and/orinsert comments or impressions. All the status modifications and/orchanges and/or inserted information are propagated through the systemserver to all other vital signs monitoring stations instantly or nearlyinstantly. The monitoring stations can also display the full-disclosurevital signs signals with different color than the uncompressed/unreducedvital signs signals fragments. Therefore the operators/consultants,aware of the lossy-compressed/bit-reduced or channel-reduced signalslimitations, can remotely request from the portable patients' monitors,additional uncompressed/unreduced vital signs signals fragments forverification, in case of significant events that were not automaticallyselected for representation with the uncompressed/unreduced data. Anyfragment of the full-disclosure vital signs can be requested, since theentire uncompressed unreduced vital signs representation signals arestored in the portable monitor's memory.

The technology can include a system for outpatient monitoring ofpatients' status, based on automated analysis of vital signs signals andsubjectively indicated symptoms, marked by the patient with the use ofinteractive interface of the patient's monitor, allowing for correlationof the objectively detected events and/or the subjective events. Thevital signs signals can be acquired through a sensor by a portablepatients' monitor. The portable monitor can analyze the signals inreal-time and can generate vital signs signals interpretationinformation. Based on the interpretation results significant/emergencyevents associated with patient state are detected. In addition, thepatient, with the use of an interactive interface of the portablepatient monitor, can indicate that he/she felt symptom or symptoms. Thepatient and/or the operator can determine additional information relatedto the symptoms occurrence, such as patient's activity when the symptomhappened, and/or the type of felt symptom or symptoms.

The full-disclosure signals along with the additional data includinginterpretation results and the patient reported symptoms can be storedin digital files and transmitted via a bandwidth-limited communicationchannel (e.g. mobile telephony network) with the use of any type oftransmission mechanism, e.g., file transfer protocol to a system serverconnected to the Internet. The entire vital signs signals with theadditional data are stored in the portable patients' monitor for laterreference and remote or direct retrieval.

In other examples, the patient monitor provides interactive tools forreal-time symptomatic events reporting, enabling for synchronization ofthe felt symptoms with symptoms represented in the vital signs signalsand the signals annotations.

The outpatient vital signs signals monitoring system can utilize anytype of network (e.g. a mobile telephony network, otherbandwidth-limited communication network, etc.) advantageously enablingfor data exchange between a patient's monitor at a patient's locationand a physician/specialist from a remote location.

In some examples, the system transmits lossy-compressed/bit-reduced orchannel-reduced full-disclosure signals representation and enablesremote consultations and verification and post-processing of theautomatically generated interpretation results and the full-disclosuresignals. The system, despite bandwidth limitation of the wirelessnetwork transmission channel, can enable access to the full-disclosuresignals representations with interpretation results from remote locationdue to utilizing lossy compression/bit reduction algorithm, or channelreduction approach. The system, with the use of a portable patient'smonitor which is a microcomputer with built in wireless networkcommunication module, can automatically interpret the vital signssignals in real-time, stores the results in memory and transmits theinterpretation results, along with the signals, to the remote systemserver.

In other examples, the transmitted lossy-compressed/bit-reduced orchannel-reduced representation signals are accompanied by a limitednumber of uncompressed/unreduced signals fragments, representingsignificant signals events. The plurality of remote monitoring computerstations, in connection with the system server thought a network (e.g.,internet, wide area network, etc.), can download and/or can visualizethe signals and the interpretation results. The monitoring computerstations, operated by consultants, can modify and/or change theautomatically generated vital signs interpretation results andpost-process and post-analyze the full-disclosure signals and/or allowfor inserting additional comments or impressions. The insertedinformation and/or the modifications are propagated through the systemserver to other monitoring computer stations. Such information exchangecan be viewed as consultations between the monitoring computer stations'operators. The operators, after initial review of thelossy-compressed/bit-reduced/channel-reduced full-disclosure vital signssignals can remotely request, from the portable patient monitors'memory, additional uncompressed/unreduced vital signs signals fragmentsfor more thorough analysis and/or verification.

In some examples, the system transmits full-disclosure signals withautomatically generated signals' description and information related tosubjective symptoms marked by the patient, allowing for correlation andreporting of the automatically detected and manually marked events.

In other examples, the system, with the use of a portable patient'smonitor, which is a microcomputer with built in mobile telephony orwireless network communication module, automatically interprets thevital signs signals in real-time, can store the results in memory andcan transmit, on an ongoing basis, the interpretation results foremergency events, along with the signals and information related to thesubjective symptoms, to a remote monitoring center. The patient, withthe use of interactive user interface of the portable patient monitor,can manually report subjective symptoms with indication of the symptomscharacteristics and information describing patient's activity duringwhich, or circumstances under which the felt symptoms occurred.

FIG. 1 is an illustration of the system 100 diagram for providing remoteoutpatient real-time vital signs signals monitoring with the capabilityof tele-consultations between the system operators/specialists operatingthe vital signs data reviewing and tele-consultation stations 110A, B, Cthrough Z-1 and Z, being connected to the system server 109 (e.g.,directly via a network, indirectly via a network, etc.). The patient'sportable monitor 101 transmits the data, through a network 107 (e.g., amobile telephony network, a wireless network, etc.) and/or through theInternet 108 to the system server 109. The other patients' portablemonitors 101 through 101 z transmit the data to the system server 109.The system 100 includes, but is not limited to, the followingcomponents:

-   -   1) Portable monitor 101—a microcomputer connected to a vital        signs signals sensor 106 with built in wireless network        transceiver (e.g., a global system for mobile communication        (GSM) module) 102, central processing unit (CPU) 105 for data        processing, random access memory (RAM) 103 and storage memory        104 for storing the signals and processing results with the use        set of programmed instructions for real-time vital signs signals        interpretation, compression and communication management.    -   2) Vital signs signals data reviewing, post-processing and        tele-consultation station 110—monitoring computer station with        software for data downloading, storing and propagating the        inserted and generated, by the operator, additional analysis        results, and results modifications and other inserted        information related to the diagnostic session from the operated        monitoring computer station to all other monitoring computer        stations assigned to the diagnostic session, through the system        server.    -   3) System server 109 with software for communication management        between the patients' monitors and the vital signs data        reviewing and tele-consultation stations and distributing the        inserted information between the vital signs data reviewing and        tele-consultation station.

When the portable monitor based software detects pathological/emergencyevents, the software can automatically select and senduncompressed/unreduced vital signs signals strips representing theseevents, along with the lossy-compressed/bit-reduced/channel reducedfull-disclosure signal segment and the interpretation resultsrepresenting this segment. The interpretation results and thefull-disclosure signal segments can be, for example, streamed to thesystem server in short time intervals.

FIG. 2 is an illustration of the full-disclosure data flow scheme 200between the portable monitor 201 and the vital signs data reviewing,post-processing and tele-consultation station, i.e. the vital signssignals monitoring computer station 214. The vital signs signal data istransmitted through the mobile telephony or other wireless network 210and further through the Internet 221 to the system server 211. Thescheme includes, but is not limited to, the following components:

-   -   1) Portable monitor 201 a microcomputer with memory for storing        the vital signs signals 202 in the following forms:        full-disclosure uncompressed/unreduced signals representation        203, full-disclosure        lossy-compressed/bit-reduced/channel-reduced signals        representation 205, uncompressed I unreduced signals fragments        204 representing significant signal events; hardware diagnostic        information 206 including memory status information and        communication errors list; monitoring settings 207 information,        including communication settings 208 with server IP and port        number and signals analysis settings 209 with the analysis        parameters and thresholds.    -   2) System server 211—including database 212 and the data        management module 213 for exchanging information between the        portable monitors 201 and the monitoring computer stations 214.    -   3) Monitoring computer station with software 214—including the        downloading module 218 with RAM 219 and storage memory 220 for        vital signs signals download operations (e.g., obtaining the        data signals representative of the patients' vital signs) and        storing, the verification module 215 for reviewing and        requesting uncompressed/unreduced signals strips 216 from the        remote portable patient's monitor, and for modifying the        portable patient's monitor settings 217.

In some examples, the portable monitor 201 acquires data signalsrepresentative of patients' vital signs, interprets the representativedata signals, and generates interpretation result data based on thesame.

In other examples, the portable monitor 201 operates in real-time andcontinuously generates the data signals representative of the patients'vital signs, the interpretation result data, and/or a hardware statusdata of the portable monitor 201. The hardware status data can includeinformation describing the portable monitor's battery status (e.g., 80%,five minutes until battery failure, etc.), memory status (e.g., 90%memory capacity, four megabytes available, etc.), and/or a mobiletelephony communication error list (e.g., 80% communication failurerate, five packets transmission attempts, or four packets lost in thepast sixty seconds, etc.).

In other examples, the monitoring computer station includes a displaymodule (not shown), a revision module (not shown), and/or asynchronization module (not shown). The display module enables viewingof the data signals representative of the patients' vital signs. Therevision module enables the correcting and/or affixing comments to theinterpretation result data. The synchronization module enablessynchronizing the revised interpretation result and post-processingresults data with a data interpretation center and repository (e.g.,off-site data storage facility, etc.). The synchronization between themonitoring computer station and the data interpretation center andrepository can occur remotely. The synchronization between themonitoring computer station and the data interpretation center andrepository can occur based on revised interpretation result data and/orinterpretation data generated during post-processing and/or any othercondition.

FIG. 3 is an illustration of the tele-consultations data flow scheme 300between the monitoring computer stations 301 through 301 z and theportable patient's monitors 316 through the mobile telephony or wirelessnetwork 315 and further through the Internet 311. The scheme includes,but is not limited to, the following components:

-   -   1) Monitoring computer station 301 exchanging two sets of data:        -   Data set A 302 exchanged only between the computer stations            including:            -   events status modifications 303,            -   interpretation results changes 304,            -   analysis reports changes 305,            -   patients' personal info changes 306,            -   consultants' personal info changes 307;        -   Data set B 308 exchanged between the computer stations 301            and the portable monitor 316, including:            -   information regarding the requested uncompressed signals                fragments 309,            -   signals monitoring settings changes 310;    -   2) System server 314—including database 313 and consultations        data synchronization module 312 for exchanging information from        data set B 308 between the monitoring computer stations 301 and        the portable patient's monitors 316, and for        synchronizing/exchanging information from data sets A 302 and B        308 between the operated monitoring computer station 301 all        other monitoring computer stations 301 assigned to the same        diagnostic session.    -   3) Portable patient monitor 316 receiving and responding to the        uncompressed signals fragments requests and the signals        interpretation settings changes from data set B 308.

FIG. 4 is an illustration of real-time outpatient interactive andfull-disclosure vital signs signals monitoring system for symptomaticevents recording and correlation with automatically detected signalevents 400. The system scheme includes, but is not limited to, thefollowing components: portable patient monitors 401 through 401 z, eachincluding vital signs signals sensor 402, acquisition module 403 forvital signs signals acquisition, signal analysis module 404 forautomatic signals interpretation, interactive user interface forreporting subjective symptoms 407 felt by the patient, recording module405 for storing interactive interface operations introduced by thepatient and transmission module 406 for transmitting the vital signssignals, the interpretation results and the manually triggeredsymptomatic events information through the mobile telephony or wirelessnetwork 408 and further through the Internet 409 to the remotemonitoring stations 410, operated by trained specialists, responsiblefor reviewing the signals, verifying the automatically generatedinterpretation results, post-processing the full-disclosure signals andfor generating diagnostic reports during and after the diagnosticsession.

The systems, stations, monitors, and/or components described herein can,for example, utilize the CPU to execute computer executable instructionsand/or include a processor to execute computer executable instructions(e.g., an encryption processing unit, a field programmable gate arrayprocessing unit, etc.). It should be understood that the systems,stations, and/or monitors can include, for example, other modules,devices, and/or processors known in the art and/or varieties of theillustrated modules, devices, and/or processors.

FIG. 5 is a flowchart 500 illustration of a method for remote monitoringof patient's state associated with interpretation results datarepresentative of patients' vital signs. The method includes, but is notlimited to, the following steps:

-   -   1) Initializing of the monitoring session 502 through the        portable patient's monitor 501 interface;    -   2) Transmitting of the vital signs signals and the automatically        generated interpretation results 503 to a remote location,        through a bandwidth-limited communication channel 504, to the        system server 505, accessible via Internet 506;    -   3) Associating of the initialized monitoring session ID with the        patient's personal data and with the trained specialist's        personal data 508 with the use of the specialist's computer        station 507;    -   4) Verifying of the automatically generated signal        interpretation results 509, including post-processing of the        signal and inserting additional comments, related to the        interpretation; and    -   5) Synchronizing of the post-processing interpretation        modifications and the inserted comments with the server        repository 510.

FIG. 6 is a flowchart 600 illustration of a method for remote monitoringof patients' state associated with analysislossy-compressed/bit-reduced/channel-reduced full-disclosure vital signssignals. The method includes, but is not limited to the following steps:

-   -   1) Receiving a lossy-compressed and/or bit-reduced and/or        channel-reduced full-disclosure signals data representative of        patient's vital signs 602 from the portable patient's monitor        608, through a bandwidth-limited communication channel 607, via        the system server 606 accessible through the Internet 605;    -   2) Visually reviewing the        lossy-compressed/bit-reduced/channel-reduced full-disclosure        vital signs signals 603 with the use of the specialist's        computer station 601; and    -   3) Remotely requesting additional uncompressed/unreduced signals        fragments, representing significant signal events, for        verification and more detailed analysis and signal measurements        604 from the patient's monitor 608, through the        bandwidth-limited communication channel 607, via the system        server 606 accessible through the Internet 605;

FIG. 7 is a flowchart 700 illustration of a method for remote andreal-time monitoring of patient's state associated with analysis offull-disclosure vital signs signals. The method includes, but is notlimited to the following steps:

-   -   1) Receiving at remote location full-disclosure vital signs        signals with the automatically generated interpretation results        702, from the portable patient's monitor 708, through a        bandwidth-limited communication channel, via the system server        705 accessible through the Internet 706, on an ongoing basis        during the monitoring;    -   2) Reviewing 703, with the use of specialist's computer station        701, the full-disclosure vital signs signals and the        automatically generated analysis results on an ongoing basis,        during the monitoring; and    -   3) Post-processing of the received full-disclosure signals, with        the use specialist's computer station 701, in order to generate        more detailed/more accurate interpretation results and reporting        the results and the manually indicated patient's symptoms on an        ongoing basis, during the monitoring 704.

In other examples, the portable patient's monitor 708 transmits 709 theremote location full-disclosure vital signs signals with theautomatically generated interpretation results to the specialist'scomputer station 701 through a bandwidth-limited communication channel,via the system server 705 accessible through the Internet 706.

The above-described systems and methods can be implemented in digital,electronic circuitry, in computer hardware, firmware, and/or software.The implementation can be as a computer program product (i.e., acomputer program tangibly embodied in an information carrier). Theimplementation can, for example, be in a machine-readable storage deviceand/or in a propagated signal, for execution by, or to control theoperation of, data processing apparatus. The implementation can, forexample, be a programmable processor, a computer, and/or multiplecomputers.

A computer program can be written in any form of programming language,including compiled and/or interpreted languages, and the computerprogram can be deployed in any form, including as a stand-alone programor as a subroutine, element, and/or other unit suitable for use in acomputing environment. A computer program can be deployed to be executedon one computer or on multiple computers at one site.

Method steps can be performed by one or more programmable processorsexecuting a computer program to perform functions of the invention byoperating on input data and generating output. Method steps can also beperformed by and an apparatus can be implemented as special purposelogic circuitry. The circuitry can, for example, be a FPGA (fieldprogrammable gate array) and/or an ASIC (application-specific integratedcircuit). Modules, subroutines, and software agents can refer toportions of the computer program, the processor, the special circuitry,software, and/or hardware that implement that functionality.

Processors suitable for the execution of a computer program include, byway of example, both general and special purpose microprocessors, andany one or more processors of any kind of digital computer. Generally, aprocessor receives instructions and data from a read-only memory or arandom access memory or both. The essential elements of a computer are aprocessor for executing instructions and one or more memory devices forstoring instructions and data. Generally, a computer can include, can beoperatively coupled to receive data from and/or transfer data to one ormore mass storage devices for storing data (e.g., magnetic,magneto-optical disks, or optical disks).

Data transmission and instructions can also occur over a communicationsnetwork. Information carriers suitable for embodying computer programinstructions and data include all forms of non-volatile memory,including by way of example semiconductor memory devices. Theinformation carriers can, for example, be EPROM, EEPROM, flash memorydevices, magnetic disks, internal hard disks, removable disks,magneto-optical disks, CD-ROM, and/or DVD-ROM disks. The processor andthe memory can be supplemented by, and/or incorporated in specialpurpose logic circui

To provide for interaction with a user, the above described techniquescan be implemented on a computer having a display device. The displaydevice can, for example, be a cathode ray tube (CRT) and/or a liquidcrystal display (LCD) monitor. The interaction with a user can, forexample, be a display of information to the user and a keyboard and apointing device (e.g., a mouse or a trackball) by which the user canprovide input to the computer (e.g., interact with a user interfaceelement). Other kinds of devices can be used to provide for interactionwith a user. Other devices can, for example, be feedback provided to theuser in any form of sensory feedback (e.g., visual feedback, auditoryfeedback, or tactile feedback). Input from the user can, for example, bereceived in any form, including acoustic, speech, and/or tactile input.

The above described techniques can be implemented in a distributedcomputing system that includes a back-end component. The back-endcomponent can, for example, be a data server, a middleware component,and/or an application server. The above described techniques can beimplemented in a distributing computing system that includes a front-endcomponent. The front-end component can, for example, be a clientcomputer having a graphical user interface, a Web browser through whicha user can interact with an example implementation, and/or othergraphical user interfaces for a transmitting device. The components ofthe system can be interconnected by any form or medium of digital datacommunication (e.g., a communication network). Examples of communicationnetworks include a local area network (LAN), a wide area network (WAN),the Internet, wired networks, and/or wireless networks.

The system can include clients and servers. A client and a server aregenerally remote from each other and typically interact through acommunication network. The relationship of client and server arises byvirtue of computer programs running on the respective computers andhaving a client-server relationship to each other.

Packet-based networks can include, for example, the Internet, a carrierinternet protocol (IP) network (e.g., local area network (LAN), widearea network

(WAN), campus area network (CAN), metropolitan area network (MAN), homearea network (HAN)), a private IP network, an IP private branch exchange(IPBX), a wireless network (e.g., radio access network (RAN), 802.11network, 802.16 network, general packet radio service (GPRS) network,HiperLAN), and/or other packet-based networks. Circuit-based networkscan include, for example, the public switched telephone network (PSTN),a private branch exchange (PBX), a wireless network (e.g., RAN,bluetooth, code-division multiple access (CDMA) network, time divisionmultiple access (TDMA) network, global system for mobile communications(GSM) network), and/or other circuit-based networks.

The transmitting device can include, for example, a computer, a computerwith a browser device, a telephone, an IP phone, a mobile device (e.g.,cellular phone, personal digital assistant (PDA) device, laptopcomputer, electronic mail device), and/or other communication devices.The browser device includes, for example, a computer (e.g., desktopcomputer, laptop computer) with a world wide web browser (e.g.,Microsoft® Internet Explorer® available from Microsoft Corporation,Mozilla® Firefox available from Mozilla Corporation). The mobilecomputing device includes, for example, a Blackberry®.

Comprise, include, and/or plural forms of each are open ended andinclude the listed parts and can include additional parts that are notlisted. And/or is open ended and includes one or more of the listedparts and combinations of the listed parts.

One skilled in the art will realize the invention may be embodied inother specific forms without departing from the spirit or essentialcharacteristics thereof. The foregoing embodiments are therefore to beconsidered in all respects illustrative rather than limiting of theinvention described herein. Scope of the invention is thus indicated bythe appended claims, rather than by the foregoing description, and allchanges that come within the meaning and range of equivalency of theclaims are therefore intended to be embraced therein.

1-13. (canceled)
 14. A method for remote monitoring of patients' stateassociated with interpretation results data representative of thepatients' vital signs, comprising the steps of: remotely initializing atleast one monitoring session having an associated unique identificationnumber; obtaining the sessions' identification number; associating apatients' personal data and a consultants' personal data with theobtained sessions' identification number; transmitting vital signssignals with interpretation results; verifying the interpretationresults data and/or post-processing the received signals data and/orinserting comments to the interpretation results data; and synchronizingthe verified or commented on interpretation results data with a datainterpretation center and repository.
 15. The method of claim 14,wherein the sessions' identification number is a combination of thesession initialization time, date, and a portable monitor'sidentification number.
 16. The method of claim 14, further comprisingcreating an event list based on interpretation results data, each eventhaving an unconfirmed status indicator.
 17. The method of claim 16,further comprising changing the unconfirmed status indicator to aconfirmed status indicator when the event has been detected properly,deleted, determined to be a false event, determined to be unclear, orwhen the consultant is not sure whether it is a true event or anincorrectly detected event.
 18. A computer program product, tangiblyembodied in an information carrier, the computer program productincluding instructions being operable to cause a data processingapparatus to: remotely initialize at least one monitoring session havingan associated unique identification number; obtaining the sessions'identification number; associate a patients' personal data and aconsultants' personal data with the obtained sessions' identificationnumber; transmit vital signs signals with interpretation results; verifythe interpretation results data and/or post-processing the receivedsignals data and/or inserting comments to the interpretation resultsdata; and synchronize the verified or commented on interpretationresults data with a data interpretation center and repository.